Culturally Responsive Nursing Care (18)

Question 1

The major factor contributing to the increased emphasis on the need for proficiency in cultural nursing practice in the United States is which of the following?

1. An increasing birth rate
2. Increased access to health care services
3. Demographic changes
4. A decreasing rate of immigration

Answer 1

3. Demographic changes

There is an ongoing shift in the U.S. popula- tion that includes a decreasing number of White Americans (formerly the majority population) and an increasing number of other cultural groups. The birth rate is actually decreasing (option 1); limited access to health care is a complex issue that is not the major factor here (option 2); and immigration has increased (option 4).

Question 2

Which behavior is an initial step in culturally responsive nursing practice?

1. Help the client recognize the need to adapt health practices to fit commonly accepted practices.
2. Discuss the meaning of the medical regimen with the client.
3. Inform the client that lack of adherence to the medical regimen may be detrimental.
4. Ask a cultural broker to explain the relevance of the intervention.

Answer 2

2. Discuss the meaning of the medical regimen with the client.

Cultural differences may result in various interpretations of a medical regime. Cultural competence results in recognition of the right “not to fit.” This is a standard of practice and should be initiated with all clients (option 1). Teaching or explaining the effects of lack of adherence would be more appropriate than warn- ing (option 3). Asking a person of the same culture to assist may be helpful after the nurse discusses the matter with the client (option 4).

Question 3

In initiating care for a client from a different culture than the nurse, which of the following would be an appropriate statement?

1. “Since, in your culture, people don’t drink ice water, I will bring you hot tea.”
2. “Do you have any books I could read about people of your culture?”
3. “Please let me know if I do anything that is not acceptable in your culture.”
4. “You will need to set aside your usual customs and practices while you are in the hospital.”

Answer 3

3. “Please let me know if I do anything that is not acceptable in your culture.”

The nurse should indicate that he or she is open to diverse views and practices. Option 1 assumes the client follows
this particular cultural practice, which may not be the case. The nurse should assess before intervening. It may be good to learn more about the culture (option 2), but that is not the best starting place to care for the client. Subcultures exist among all cultures. Reading books is help- ful, but assessment of individual situations is the best approach. Op- tion 4 reflects an incorrect approach to culturally appropriate care. The nurse needs to assess which customs and practices the individual client performs before drawing conclusions.

Question 4

Which behavior is most representative of a culturally competent nurse?

1. Helps clients of Native American heritage identify ways to relate more to their culture.
2. Helps parents of Latino heritage recognize that their children need to speak English.
3. Interprets and validates beliefs of a client with African American heritage.
4. Asks a nurse of Japanese heritage to teach others dosage calculations since Asians are good at math.

Answer 4

3. Interprets and validates beliefs of a client with African American heritage.

Culturally competent implies that, within the delivered care, the nurse understands and attends to the total context of the client’s situation, including awareness of immigration, stress factors, and cultural differences. Options 1 and 2 do not show that the nurse needs to respect the choices made by the clients. Option 4 shows bias or stereotyping.

Question 5

An outcome of achieving national cultural health goals would be which of the following?

1. All cultures receive the same health care.
2. All people have the same life expectancy.
3. All U.S. residents have access to the same quality of health care.
4. All cultures are fully assimilated into the dominant society.

Answer 5

3. All U.S. residents have access to the same quality of health care.

National cultural health goals include providing equal access to quality health care for everyone. It would be inappro- priate for all cultures to receive the same care; care should be custom- ized (option 1). The same life expectancy for all U.S. citizens is not realistic (option 2). Assimilation (option 4) is not an appropriate health goal because assimilation is a conscious effect. Therefore, it is not always possible and this may cause severe stress and anxiety.

Question 6

Which nursing action primarily supports restoring HEALTH using traditional methods?

1. Herbal teas
2. Prayer
3. Wearing symbolic objects
4. Exercise

Answer 6

1. Herbal teas

Herbal teas are an example of a restoring health ac- tion. Prayer (option 2) and exercise (option 4) would be examples of main- taining actions, whereas wearing symbolic objects (option 3) is a protective action.

Question 7

A client with strong preferences for folk healing methods would prefer which of the following to treat a sinus infection?

1. Hospitalization
2. Steam humidifier
3. Antibiotic therapy
4. “Watch and wait”

Answer 7

2. Steam humidifier

Steam is a natural substance and would be com- patible with folk healing preferences. Hospitalization and medications are typical Western medical strategies (options 1 and 3). A watch-and- wait approach (option 4) is not particularly associated with a folk heal- ing perspective.

Question 8

Which of the following factors are most likely to be influenced by culture as opposed to personal characteristics? Select all that apply.

1. Value of older people in society
2. Gender roles
3. Nonverbal gestures
4. Skill with technology
5. Intelligence
6. Diet

Answer 8

1. Value of older people in society
2. Gender roles
3. Nonverbal gestures
4. Diet

Technology skills (option 4) and intelligence (option 5) are individual, personal characteristics and less influenced by one’s culture than valuing of elders (option 1), gender roles (option 2), nonverbal communication (option 3), or diet (option 6). Culture may, however, influence how technologic skills (option 4)
and intelligence (option 5) are viewed and valued.

Question 9

What is the most productive method of gathering assessment data regarding heritage?

1. Physical exam
2. Medical history
3. Blood analysis
4. Traditional beliefs and practices checklist

Answer 9

4. Traditional beliefs and practices checklist

To gather assessment data regarding the client’s heritage, nurses must explore clients’ beliefs and practices. A good beginning would be to ask clients to indicate from the checklist which apply to them. Physical exam (option 1) and medical history (option 2) may suggest some cultural affiliation but the nurse cannot assume that these findings show significant affiliation from the client’s perspective. Blood analysis generally provides little data for a heritage assessment although blood type and some immunologic or genetic data can be rel- evant (option 3).

Question 10

A client who speaks limited English requires instructions for a test. No one at your agency speaks the person’s language. What is the nurse’s best approach?

1. Provide the instructions in writing.
2. Locate a professional interpreter.
3. Ask a family member to translate on the phone.
4. Document that the required instruction is not possible.

Answer 10

2. Locate a professional interpreter.

If an interpreter is not available at your agency, you must still meet the expectations of providing information in a way the client can comprehend it. Providing written instructions, whether in English or the client’s language, is insufficient since the client may not be able to read and remains unable to have questions answered (option 1). Family members should not be relied on to interpret medical information (option 3). Option 4 is not an appropriate action.